Tuesday: Family Conversations

Podcast length: 16:51

AOTA Podcast: While family and friends play a major role in discussions about older driver safety, many people put off a conversation about an older family member’s or friend’s abilities because they may be unsure how to start it, when to approach it, or how to remain respectful of their loved one.

In this 16-minute podcast, (listen on player to the right or download the file here), Elin Schold Davis, program manager of AOTA’s Older Driver Initiative, and Julie Lee, Vice President and National Director of AARP Driver Safety, will focus on breeching the conversation about driving ability with a loved one. Topics covered include timing conversations about driving ability, why the holidays are an important time to take notice of a loved one’s driving, occupational therapy’s role in facilitating conversations between families, and AOTA and AARP resources.

AOTA's Older Driver Safety Awareness Week seeks to raise awareness and increase the availability of education about the aging driver's options. Each day of the week, AOTA spotlights a different aspect of older driver safety.

Family and friends play a major role in discussions about older driver safety, and we are now recognizing the importance of starting these conversations earlier, before a crisis. "When an older adult is given a traffic ticket or has a minor crash, it may feel like a natural time to discuss safety in driving," says Mary Jo McGuire, MS, OTR/L, OTPP, FAOTA. "The problem is that this is when an older adult feels he or she must defend the ability to drive, and so the conversation with family members can, unfortunately, become argumentative."

Many older adults may think about what they can do to remain fit to drive as long as safely possible while silently wondering if a day will come when they might have to stop driving. Early conversations between families and friends can bring up questions that focus on the importance of physical and mental health to preserve essential driving skills as well as options supporting an engaged life after driving, such as, "how do you think you could get to church if you ever quit driving?"

"With this approach, the older adult is given hope of continued participation in community events after making the difficult decision of driving retirement," says McGuire. "Older adults do not want to be a burden on others, so providing additional information such as offering to pick up the older adult for church and combining the ride with a social brunch after the service can help prepare for a time when help must be accepted."

These conversations are easier when started while an older adult is still a competent driver, when the focus is on preparing, in like manner to preparing for finances and housing, such as making minor changes in routes to destinations or mid-day appointments, without worrying about having to stop driving immediately, according to McGuire. She suggests using current events, such as a news story about a car accident, as an opportunity to explore driver safety. This is also a time to emphasize the initial focus on solutions. Explore interventions and adaptations available to support an older adult in his or her goal to continue driving safely, compensating with guidance from health professionals for physical or cognitive changes. These can be as simple as avoiding the unprotected left turn or not driving at night, or as complex as vehicle adaptations.

Other opportunities for discussing driver safety include making positive comments when transporting an older adult somewhere, such as "it's nice to spend time with you" or "I'm glad you let me drive today"; creating a positive attitude toward an engaged and active life without dependence on driving responsibilities, such as not having the cost of keeping up a car and paying insurance; and discussing the possibility of limiting when or where the person drives, in order to increase safety.

Another option that occupational therapy practitioners suggest is that older drivers and their families select a family member or friend to be a "driving advocate" who will commit to ride with the older driver on a regular basis and will voice concerns and give advice. A "contract" between the older driver and selected family can clarify the commitment to explore all possible services and solutions and make clear the wish to make the safest decision if medically related changes have "taken away" the essential skills and abilities required to control a vehicle safely. Remember to never have these conversations in the car, and be specific about the unsafe behavior.

"Everyone is different, and the solutions need to be custom designed for each individual," says McGuire. "It is often hard for families, and this is part of the reason occupational therapy is an important part of society—occupational therapy practitioners have special skills for considering all the factors." Occupational therapy practitioners can provide families with materials on older driver safety, support families when bringing up the topic, and look at older adults holistically to provide tailored information. "Driving is a critical occupation that we need to understand and analyze," says McGuire. "It is one part of the larger issues of community mobility, which is a critical component of being able to live life to its fullest."